Rheumatoid arthritis not responding to treatment

Continuing joint pain, swelling, or morning stiffness may mean that inflammation is still active. Symptoms can also persist when a medicine has not had enough time to work, doses are missed, the dose is no longer suitable, or another condition is causing pain. A flare may affect the hands, feet, wrists, knees, or other joints. Tracking which joints change, how long stiffness lasts, and how daily tasks are affected gives the clinician useful detail.

Do not stop or change prescribed rheumatoid arthritis medicine without medical advice. Some medicines need monitoring, and sudden changes can allow inflammation to return. A review may include an examination, blood tests, or scans chosen according to your symptoms.

Arrange an appointment with the clinician managing your rheumatoid arthritis. Bring a list of every medicine and supplement, including how regularly you take each one, and note recent infections or side effects. Record pain, swelling, morning stiffness, fatigue, and activities you can no longer manage. Ask whether the diagnosis, treatment target, dose, or combination of medicines should be reassessed. Rest during a flare, but gentle movement within comfort can help prevent extra stiffness. Guidance about anti-inflammatory medication should be individualised.

Seek urgent medical help for a hot, very swollen joint with fever or feeling severely unwell, because infection needs prompt assessment. Get immediate help for sudden weakness, loss of bladder or bowel control, new trouble speaking, chest pain, or severe breathing difficulty. Contact your rheumatology team soon if swelling is rapidly increasing, pain is difficult to control, or medicine side effects are concerning.

Could active inflammation explain my symptoms? How will we measure whether treatment is working? Should any medicine, dose, or monitoring plan change? Could an infection, injury, or another condition be contributing? What movement is appropriate during a flare?